Investigator(s)
| WHO Technical Officer |
Katrin Bote WHO SEARO -Neglected Tropical Diseases Katrin Bote 
|
| Principal Investigator |
Md. Mahfuzur Rahman Interactive R&D Bangladesh (IRD Bangladesh), Florida Castle, Suite E2, House # 7, Road # 23/A, Gulshan-1, Dhaka-1212. Md. Mahfuzur Rahman
|
Title(s) and abstract
| Scientific title | Evaluating Ambulatory Care for Drug-Resistant Tuberculosis in Bangladesh: A Mixed-Methods Study |
| Public title | Evaluating Ambulatory Care for Drug-Resistant Tuberculosis in Bangladesh: A Mixed-Methods Study |
| Background | Drug-resistant tuberculosis (DR-TB) continues to pose a significant global health threat, with an alarming increase in incident cases and related deaths in 2021. The transition to all-oral regimens and ambulatory care presents an opportunity to improve DR-TB treatment, ensuring shorter regimens, reduced discomfort, and enhanced patient compliance. Bangladesh, categorized as a high TB burden country, grapples with significant TB challenges, particularly in managing DR-TB. The prevalent hospitalization-based approach poses difficulties for patients, especially those in remote regions. |
| Objectives | In response, the National Tuberculosis Control Program (NTP) is transitioning towards "Zero-day" ambulatory treatment for DR-TB patients. However, implementing ambulatory treatment introduces its unique set of challenges, including treatment regimen selection, and management of adverse drug reactions, especially in sub-district facilities. These facilities often lack experienced doctors, with frequent turnover exacerbating the shortage of trained physicians for DR-TB management. Moreover, logistical hurdles hinder the timely and reliable transportation of sputum samples for second-line drug-susceptibility testing. |
| Study Methods | Our proposal is to evaluate the complete care pathway of ambulatory treatment: diagnostic pathway, treatment pathway, sample transportation, capabilities of healthcare workers, patient satisfaction, and system readiness. This evaluation will also capture the viewpoints of both healthcare workers and patients and will inform the NTP’s optimization of ambulatory DR-TB treatment. Our evaluation approach includes a concurrent, mixed-methods design. The proposed methods for this IR will aid in identifying challenges, bottlenecks, and solutions, including insights from grassroots perspectives. |
| Expected outcomes and use of results | Through this research project, IRD Bangladesh aims to comprehensively evaluate the implementation challenges of ambulatory DR-TB treatment in Bangladesh, identify the bottlenecks and opportunities to further refine the patient care pathway. Utilizing a mixed-methods approach, this project seeks to formulate evidence-based recommendations to the policy makers that can instigate positive changes in DR-TB ambulatory care. |
| Keywords | tuberculosis, drug resistance, ambulatory treatment |
Research Details
| Student research | No |
| Start Date | 01-Jan-2024 |
| End Date | 31-Dec-2024 |
| Key Implementing Institution | Interactive R&D Bangladesh |
| Multi-country research | No |
| Nationwide research | No |
| Bangladesh | |
| Research Domain(s) | Communicable Disease Research |
| Research field(s) | Tuberculosis |
| Involves human subjects | Yes |
| Health System and Policy Research | |
| Data Collection | Primary and secondary data |
| Proposal reviewed by other Committee | No |